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Speed of Onset and Offset and Mechanisms of Ventilatory Depression from SevofluraneAn Experimental Study in the Cat

 

作者: Albert Dahan,   Erik Olofsen,   Luc Teppema,   Elise Sarton,   Cees Olievier,  

 

期刊: Anesthesiology  (OVID Available online 1999)
卷期: Volume 90, issue 4  

页码: 1119-1128

 

ISSN:0003-3022

 

年代: 1999

 

出版商: OVID

 

关键词: Central chemoreceptors;control of breathing;Hill equation;modeling;peripheral chemoreceptors;pharmacodynamics;respiration;ventilation.

 

数据来源: OVID

 

摘要:

BackgroundInhalation anesthetics depress breathing dose dependently. The authors studied the dynamics of ventilation on changes in end‐tidal sevoflurane partial pressure. To learn more about the mechanisms of sevoflurane‐induced respiratory depression, the authors also studied its influence on the dynamic ventilatory response to carbon dioxide.MethodsExperiments were performed in cats anesthetized with [Greek small letter alpha] chloralose‐urethane. For protocol 1, step changes in end‐tidal sevoflurane partial pressure were applied and inspired ventilation was measured. Breath‐to‐breath inspired ventilation was related to the sevoflurane concentration in a hypothetical effect compartment based on an inhibitory sigmoid Emax model. For protocol 2, step changes in the end‐tidal partial pressure of carbon dioxide were applied at 0, 0.5, and 1% end‐tidal sevoflurane. The inspired ventilation‐end‐tidal partial pressure of carbon dioxide data were analyzed using a two‐compartment model of the respiratory controller, which consisted of a fast peripheral and slow central compartment. Values are the mean +/− SD.ResultsIn protocol 1, the effect‐site half‐life of respiratory changes caused by alterations in end‐tidal sevoflurane partial pressure was 3.6 +/− 1.0 min. In protocol 2, at 0.5% sevoflurane, the central and peripheral carbon dioxide sensitivities decreased to 43 +/− 20% and 36 +/− 18% of control. At 1% sevoflurane, the peripheral carbon dioxide sensitivity decreased further, to 12 +/− 13% of control, whereas the central carbon dioxide sensitivity showed no further decrease.ConclusionsSteady state inspired ventilation is reached after 18 min (i.e., 5 half‐lives) on stepwise changes in end‐tidal sevoflurane. Anesthetic concentrations of sevoflurane have, in addition to an effect on pathways common to the peripheral and central chemoreflex loops, a selective effect on the peripheral chemoreflex loop. Sevoflurane has similar effects on ventilatory control in humans and cats.

 

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